The Package of Care for Patients With Bipolar Depression

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Although pharmacotherapy is the mainstay of the comprehensive program of medical care for the management of patients with bipolar disorder, the additional benefits of psychosocial interventions for the patient, family, and caregivers are now being recognized and increasingly adopted. Several facets of bipolar disorder can be addressed more effectively by instituting adjunctive psychosocial interventions. Recent clinical evidence indicates that combining pharmacotherapy with psychosocial interventions, which are tailored to patients’ individual needs, may decrease the risk of relapse, improve patient adherence, and decrease the number and length of hospitalizations. A multidisciplinary approach may also enhance long-term patient outcomes such as mood stability, enhanced occupational and/or social functioning, and overall quality of life. Psychoeducation helps individuals become active and informed participants in the management of their illness, promoting a collaborative relationship between patients and their caregivers. However, psychosocial interventions are not useful for all patients with bipolar illness and may be more useful in addressing some problems than others. Evidence would suggest that psychosocial interventions, with continuing pharmacotherapy, are best used as prophylaxis and during periods of remission to prevent further episodes. Further randomized, clinical trials will help to define which components of psychosocial intervention are most effective in patients with bipolar disorder.

J Clin Psychiatry 2005;66(suppl 5):34-39